Experienced psychiatric nurses' clinical judgments in everyday practices.
The purpose of this study was to explore the characteristics of clinical judgment through uncovering the everyday practices of experienced psychiatric nurses. Participants were 13 nurses and 4 licensed assistant nurses who worked at a private mental hospital. The participants were interviewed and encouraged to describe their everyday practices and clinical judgment episode. The narrative texts were interpreted by the researcher in this study. As a result, the following characteristics emerged: 1) Clinical judgment embedded in everyday practices is based on the experienced nurse's expert ability of knowing the patient and grasping the patient's situation; 2) Clinical judgment is clinical wisdom, including intuition, based on the nurse's experience; 3) Clinical judgment in patient-nurse interactions is strongly affected by closeness/distance in the relationship. Clinical judgment is not context free, rather it is very situational; 4) When group consensus and the nursing care plan exert conformity pressure, the group consensus tends to obstruct the development of an individual nurse's judgment.
Nakayama
Y
Y
St. Luke's College of Nursing, Tokyo.
D002983:Clinical Competence / Q000592:standards*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007600:Judgment; D009730:Nursing Assessment / Q000592:standards*; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000193:education* / Q000523:psychology*; D011568:Psychiatric Nursing / Q000592:standards*; D011795:Surveys and Questionnaires